| National Provider Identifier [NPI]: | 1992795074 |
| Last Name Of The Provider | NUNNELLY |
| First Name Of The Provider | DAVID |
| Middle Initial Of The Provider | E |
| Credentials Of The Provider | M. D. |
| Gender Of The Provider | M |
| Entity Type Of The Provider | I |
| Street Address 1 Of The Provider | 1106 DRUID RD S |
| Street Address 2 Of The Provider | SUITE 302 |
| City Of The Provider | CLEARWATER |
| Zip Code Of The Provider | 337563846 |
| State Code Of The Provider | FL |
| Country Code Of The Provider | US |
| Provider Type Of The Provider | Diagnostic Radiology |
| Medicare Participation Indicator | Y |
| Number Of HCPCS | 215 |
| Number Of Services | 21510 |
| Number Of Medicare Beneficiaries | 3510 |
| Total Submitted Charge Amount | 1435058.21 |
| Total Medicare Allowed Amount | 376460.28 |
| Total Medicare Payment Amount | 294245.83 |
| Total Medicare Standardized Payment Amount | 299517.95 |
| Drug Suppress Indicator | |
| Number Of HCPCS Associated With Drug Services | 3 |
| Number Of Drug Services | 16220 |
| Number Of Medicare Beneficiaries With Drug Services | 180 |
| Total Drug Submitted ChargeAmount | 39804.4 |
| Total Drug Medicare AllowedAmount | 4361 |
| Total Drug Medicare PaymentAmount | 3338.05 |
| Total Drug Medicare Standardized Payment Amount | 3338.05 |
| Medical SuppressIndicator | |
| Number Of HCPCS Associated With MedicalServices | 212 |
| Number Of Medical Services | 5290 |
| Number Of Medicare Beneficiaries With Medical Services | 3506 |
| Total Medical Submitted Charge Amount | 1395253.81 |
| Total Medical Medicare Allowed Amount | 372099.28 |
| Total Medical Medicare Payment Amount | 290907.78 |
| Total Medical Medicare Standardized Payment Amount | 296179.9 |
| Average Age Of Beneficiaries | 75 |
| Number Of Beneficiaries Age Less65 | 484 |
| Number Of Beneficiaries Age 65 to 74 | 1085 |
| Number Of Beneficiaries Age 75 to 84 | 1155 |
| Number Of Beneficiaries Age Greater 84 | 786 |
| Number Of Female Beneficiaries | 2245 |
| Number Of Male Beneficiaries | 1265 |
| Number Of Non Hispanic White Beneficiaries | 3237 |
| Number Of Black or African American Beneficiaries | 95 |
| Number Of AsianPacific Islander Beneficiaries | |
| Number Of Hispanic Beneficiaries | 118 |
| Number Of American Indian Alaska Native Beneficiaries | |
| Number Of Beneficiaries With Race Not Else where Classified | 33 |
| Number Of Beneficiaries With Medicare Only Entitlement | 2755 |
| Number Of Beneficiaries With Medicare Medicaid Entitlement | 755 |
| Percent Of With Atrial Fibrillation | 22 |
| Percent Of With Alzheimers Disease or Dementia | 24 |
| Percent Of With Asthma | 12 |
| Percent Of With Cancer | 20 |
| Percent Of With Heart Failure | 36 |
| Percent Of With Chronic Kidney Disease | 42 |
| Percent Of With Chronic Obstructive Pulmonary Disease | 31 |
| Percent Of With Depression | 39 |
| Percent Of With Diabetes | 36 |
| Percent Of With Hyperlipidemia | 74 |
| Percent Of With Hypertension | 75 |
| Percent Of With Ischemic Heart Disease | 61 |
| Percent Of With Osteoporosis | 17 |
| Percent Of With Rheumatoid Arthritis Osteoarthritis | 54 |
| Percent Of With Schizophrenia Other PsychoticDisorders | 11 |
| Percent Of With Stroke | 15 |
| Average HCC Risk Score Of Beneficiaries | 1.9235 |